Der Unfallchirurg
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Bisphosphonates (BP) play an important role in the therapy of osteoporosis as they effectively reduce the risk of fractures. Atypical femoral fractures (AFF) have recently been described as an adverse effect of BP treatment. We present 3 women under therapy with BP, who had five AFF, among these three complete and two incomplete fractures. The incidence of AFF under therapy with BP is low, and the benefit regarding reduction of spinal fractures and fractures of the proximal femur is much higher than the risk for an AFF.
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Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. ⋯ Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.
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Internal fracture fixation represents a widespread concept for the treatment of fractures. As the number of implants increases, person tracking may be possible. In spring 2010 near Rostock (Germany), human remains including a stainless steel nail were found. ⋯ Equipped with the actual patient's identity, out of academic interest a survey of clinical documents such as discharge letters and operative reports was performed, but was inconclusive. Although technically feasible, tracking the patient in this case based on the implant product number itself was unsuccessful. In this case report, the feasibility, validity and efficiency of this option are presented and discussed.
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A novel radiation-free electromagnetic navigation system (ENS) method was developed and the feasibility and accuracy for transklavikular-transkorakoid drilling procedures were evaluated in an experimental setting. ⋯ The electromagnetically navigated transkorakoid-transklavikular drilling procedure used in this study demonstrated high targeting accuracy, required no intraoperative x-ray radiation and was associated with no complications.
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Displaced fractures of the acetabulum involving the quadrilateral plate continue to be a surgical challenge. In this study, we describe our operation technique of auxiliary acetabular cerclage-wiring combined with plate osteosynthesis and present our results as well as short-term outcome. ⋯ Auxiliary acetabular cerclage-wiring is a safe and effective method for fracture reduction and retention especially in displaced acetabular fractures involving the quadrilateral plate.